Unpayable medical bills: PinnacleHealth helps patients wage online campaigns for money

April 27--Even with the Affordable Care Act and a better economy, medical debt remains a big problem. Much of it results from the increasing out-of-pocket of costs faced by most people with health insurance.

In response, PinnacleHealth System has rolled out a way for patients struggling with medical bills to wage online and social media campaigns to spread word of their plights, and collect donations. "It's like a health savings account that's funded by your friends, family and co-workers," says William Pugh, PinnacleHealth's chief financial officer.

PinnacleHealth is partnering with an internet company to offer the "Hope Card," which involves a debit card patients use to pay for medical services. Moreover, it assures donors the medical need is real, and the money will go to nothing else. "There is no opportunity to game the system. These are our patients, and we know what their financial situation is," Pugh says.

Michele Paul of Lower Swatara Township was diagnosed with non-Hodgkins while in the waiting period for health benefits at her new job. The 44-year-old, who is undergoing chemotherapy, was later laid off from the job as a manager of temp workers. Her husband, Brian, is a technical writer in a contracted position with no health benefits. They have been uninsured since being laid off from other jobs last year.

They qualified for discounted care from PinnacleHealth. But the financial burden became overwhelming after Michele learned that, in preparation for a bone biopsy, she had to switch from blood thinner pills to shots, which cost much more.

PinnacleHealth connected them to the Hope Card. In mid-March, they began a campaign to raise $10,000. A month later, they had raised about $7,300, with contributions from about 70 people, and donations still coming.

HOW TO HELP: Profiles of the PinnacleHealth patients using the program, and information about how to donate, can be found here.

Michele is a Cub Scout den mother. The couple has three teenaged sons. Brian says he was emotionally distraught following the diagnosis, and at first didn't even post anything on Facebook, afraid he might see an upsetting comment. When he first learned of the Hope Card, he worried it seemed like "begging."

But loved ones had been asking how they could help. The Pauls realized the Hope Card provided a good way. They posted it on their Facebook pages, and were surprised by how many people shared it. Most donations are for $20 to $50. One came from someone Brian hasn't seen in 20 years. Many included supportive messages.

Pugh says the program won't lessen the amount of charity care provided by PinnacleHealth, and isn't intended to shift the charity care burden to others.

PinnacleHealth gives free charity care to people with incomes of 250 or less of the federal poverty level. It offers discounted care and payment plans to others who lack insurance or means of paying.

The Hope Card is for people who don't qualify for free care and, although receiving discounted care, are still struggling to pay their medical bills.

Pugh says people using the Hope Card are charged amounts similar to what health insurers pay or less, depending on their incomes. That means Hope Card funds won't be applied to full hospital charges -- the amounts which are sometimes charged to the uninsured, and which have resulted in criticism of the billing practices of many hospitals.

One possible financial benefit to PinnacleHealth, Pugh says, is that the donations might lesson the amount of bills which get written off as bad debt.

It's widely-known that people with health insurance are paying a steadily-increasing portion of their medical costs, typically in the form of co-pays and deductibles.

Around the county, some have turned to crowd-funding sites such as GoFundMe to deal with medical crises, sometimes receiving substantial help from strangers.

In the case of the Hope Card, Pugh expects the bulk of the help will come from family, friends and co-workers. However, the Hope Card web site has buttons for Facebook and Twitter. Someone with large social media networks could reach many people, with the possibility of their plea going viral.

The Hope Card differs from general crowd funding in that it involves a bank, and complies with all applicable laws, according to Pugh. "I don't want this to be some fly-by-night crowd funding thing where people don't know where the money is going," he says.

Two other PinnacleHealth patients are using the program. A self-employed truck driver from Elizabethville stricken with throat cancer has raised about $800 toward a $3,000 goal. A Harrisburg woman with lupus has raised about $300 toward a $6,000 goal. Their campaigns, launched in January, haven't caught on as quickly as the Pauls', possibly because they don't have as many social media connections.

PinnacleHealth's program is viewed as a "pilot." However, Pugh expects it will soon be used by a children's hospital in California, and predicts it will spread well beyond that. Checks with several other midstate hospital found no similar programs.

Any unused donations will be placed in a non-profit foundation associated with the Hope Card, and will help people who don't reach their fund-raising goal, according to Pugh.

Pugh says that when he was a teen, his mother became severely ill, and his family was devastated financially, losing their home. He said it has always been important to him that PinnacleHealth has programs to help people in financial need.

Michele Paul's cancer diagnosis followed a swollen arm. Worried about the cost of an exam, she waited several days before calling her doctor, who is part of PinnacleHealth. When she finally called and explained her situation, she says she was immediately told she would qualify for discounted care. Since then, PinnacleHealth providers have told her to focus on treatment, and not to worry about about cost -- even as the Pauls recently received 14 medical bills in one day.

Michele Paul, who hopes to obtain coverage through the Affordable Care Act, says PinnacleHealth and the Hope Card have provided peace of mind. "It seems like they really, really care. That's how I have felt this whole time," Brian Paul says.

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